[Progress in computerized tomography of the orbit].
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Biomedical subjects
Publications and source records attributed to U Piepgras.
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The possibilities of quantitative evaluation of skull computer tomograms were explored in a group of 22 normals and compared with a group of 26 patients with cerebral tumours. Quantitative measurements of normal cerebral tissue and of tumours have revealed mean values for these groups which permit certain fundamental conclusions.
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CT cisternography and CSF scintigraphy are indispensable in the detailed morphologic and etiologic evaluation of special types of childhood hydrocephalus. In addition these investigations afford interesting insights into CSF dynamics in apparently complete membranous or tumorous obstruction of the fourth ventricle and into the genesis of internal hydrocephalus in cerebellopontine angle tumors.
Results of microzone electrophoresis of non-concentrated CSF after staining with nigrosine and after evaluation on non-transparent acetate film are compared with those of isotope cisternography (111In-DTPA). We found that blood-CSF barrier disturbances begin with an increase of the absolute values of prealbumins in normal CSF circulation. When a barrier impairment occurs, by first increasing the absolute values of alpha1-globulins, we state a pathological CSF circulation. In this case, most of the globulin region is pathologic (globulin-type).
1. Computer tomography is much more clearly superior to cranial scintigraphy with regard to the identification and localization of pathologic infratentorial processes, than in the supratentorial range. 2. Computer tomography alone solves many diagnostic problems relating to the infratentorial range, but it cannot by any means solve all the problems. 3. The diagnosis identifying the kind of infratentorial growing and displacing tumors cannot be safely established either by computer tomography alone or by a combination of computer tomography and cranial scintigraphy. 4. Cranial scintigraphy and CSF scintigraphy can supply additional informations, support the diagnosis, or contribute towards establishing the final diagnosis, in cases where computer tomography alone supplies ambiguous, questionably positive or discrete answers. In such cases, the emphasis is on the etiologic grouping of unclear forms of hydrocephalos.
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The experiences of more than 200 cisternographic examination with 111Indium-DTPA are reported. The radiopharmaceutical was tolerated without adverse reactions and the suboccipital intrathecal injection more appropriate than the lumbar. With 111In-DTPA excellent scans were obtained up to 48 h after application. 111In is compared with other radiopharmaceuticals for cisternography. The cisternography remains valuable as an additional examination of pneumencephalography and cranial computerized tomography.
A rare anomaly is described consisting of the left vertebral artery arising from the left external artery. The developmental basis and relationships are discussed.
For the diagnosis of lumbar P.I.D. discography is much superior to myelography. The risks of both techniques are the same, but the side-effects of discography are clearly less. Higher lesions remain a problem if they do not show up neurologically (s. the prolapsed disc at L 2/3). Here segmental blocking, posterior gaping of the intervertebral space and displacement of the dural sac show clearly the posterior prolapse. In the standard discogram of the lower 3 discs it would have been missed. In spite of this our present experience with lumbar discography is so positive, that we are about to test a long term series, whether and to which extend discography could replace myelography in cases where there is no hint at a space-occupying lesion, other than a disc or whether the order of these investigations should be reversed.
The anastomosis between the vertebral artery and occipital artery in case of proximal subclavian artery occlusion is demonstrated. The reasons for development and angiographic visibility of this channel are discussed.
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